The role of quick Sepsis-related Organ Failure Assessment score as simple scoring system to predict Fournier gangrene mortality and the correlation with Fournier's Gangrene Severity Index: Analysis of 69 patients
Bambang S. Noegroho*(),Kuncoro Adi,Akhmad Mustafa*(),Rais Syaeful Haq,Zola Wijayanti,Jason Liarto
Urology Department, Hasan Sadikin Academic Medical Center, Universitas Padjadjaran, Bandung, Indonesia
Objective: Fournier's gangrene is a rare but life-threatening infection disease with high mortality rate. The quick Sepsis-related Organ Failure Assessment (qSOFA) is a new and simpler scoring system that may identify patients with suspected infection who are at greater risk for a poor outcome. The purpose of this study was to find out role of qSOFA in determining prognosis of Fournier's gangrene patients. Methods: This study is a case control with retrospective review of Fournier's gangrene patients treated at Hasan Sadikin Hospital from January 2013 to December 2017 who met inclusion criteria. Participants were divided into two groups according to qSOFA score as high qSOFA (2-3) and low qSOFA (0-1). Results: From 69 patients, the mortality rate was 24.6%. The sensitivity of qSOFA score to predict mortality was 88.2%; the specificity was 94.2%; positive predictive value was 83.3%; negative predictive value was 96.1%; positive likelihood ratio was 15.2; negative likelihood ratio was 0.12; and the area under the receiver operating characteristic curve of qSOFA was 94.2%. There was significant association between qSOFA scale and mortality with p-value of 0.0001. The qSOFA score has strong positive correlation with Fournier's Gangrene Severity Index (p<0.0001, r=0.704). Conclusion: qSOFA scoring system has a high prognostic value and can be used to determine prognosis of Fournier's gangrene patients.
. [J]. Asian Journal of Urology, 2023, 10(2): 201-207.
Bambang S. Noegroho,Kuncoro Adi,Akhmad Mustafa,Rais Syaeful Haq,Zola Wijayanti,Jason Liarto. The role of quick Sepsis-related Organ Failure Assessment score as simple scoring system to predict Fournier gangrene mortality and the correlation with Fournier's Gangrene Severity Index: Analysis of 69 patients. Asian Journal of Urology, 2023, 10(2): 201-207.
Respiratory rate, mean±SD, number of breaths per minute
21.27±2.88
26.94±5.34
0.001a
Comorbidity, n (%)
Chronic kidney disease
2 (3.8)
5 (29.4)
0.067c
Heart failure
3 (5.8)
3 (17.6)
0.101c
Diabetes
21 (40.4)
7 (41.2)
0.954c
Tuberculosis
2 (3.8)
0 (0)
0.412c
HIV
1 (1.9)
1 (5.9)
0.398c
Autoimmune
1 (1.9)
0 (0)
0.565c
Perianal abscess
16 (30.8)
9 (52.9)
0.099c
Carbuncle
19 (36.5)
6 (35.3)
0.926c
Urethral stricture
13 (25.0)
1 (5.9)
0.089c
Laboratory result, mean±SD
Hb, g/dL
11.47±3.11
10.52±2.99
0.262a
Leucocyte, number per mm3
17 423.14±9129.00
19 003.23±9696.00
0.545a
Thrombocyte, number per mm3
384 921.57±175 107.00
266 937.50±153 547.00
0.018a
Sodium, mEq/L
130.61±5.99
128.06±8.26
0.176a
Potassium, mmol/L
4.69±4.836
4.41±1.121
0.809a
BUN, mg/dL
67.43±59.94
92.94±49.98
0.095a
Creatinine, mg/dL
2.19±2.77
2.09±1.16
0.833a
HCO3?, mEq/L
22.70±13.48
26.68±12.27
0.136a
Random blood glucose, mg/dL
177.36±138.80
162.46±100.43
0.671a
Albumin, g/dL
2.383±0.894
1.730±0.404
0.017a
FGSI score, n (%)
<9
47 (90.4)
1 (5.9)
0.0001b
≥9
5 (9.6)
16 (94.1)
qSOFA score, n (%)
Low risk (0-1)
49 (94.2)
2 (11.8)
0.0001b
High risk (2-3)
3 (5.8)
15 (88.2)
Variable
qSOFA
FGSI
r-Value
p-Valuea
Sensitivity
88.2%
94.1%
0.704
0.0001
Specificity
94.2%
90.3%
Positive predictive value
83.3%
76.1%
Negative predictive value
96.1%
97.9%
Positive likelihood ratio
15.2
9.7
Negative likelihood ratio
0.12
0.065
Area under the curve
94.2%
91.2%
Author
Year
Location
Data collection duration, year
Number of patients (number of patients per year)
Mortality rate, %
Laor et al. [5]
1995
USA
15
30 (2)
43.3
Yilmazlar et al. [7]
2010
Turkey
16
120 (7)
20.5
Shukla et al. [11]
2016
India
4
57 (14)
22.5
Noegroho et al. [10]
2021
Turkey
16
120 (7)
20.5
Benjelloun et al. [12]
2013
Morocco
7
50 (7)
24.0
Yeniyol et al. [13]
2004
Turkey
5
25 (5)
24.0
Hejase et al. [14]
1996
Mexico
3
38 (3)
2.6
Tahmaz et al. [15]
2006
Turkey
15
33 (2)
6.0
Sallami et al. [31]
2012
Tunisia
15
40 (3)
17.5
McCormack et al. [32]
2015
Canada
12
26 (2)
19.2
Sánchez Mazzaferri et al. [33]
1999
Spain
10
9 (1)
22.5
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